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James J Boutrous, MD
Urology Physician in St Clair Shores, Michigan
NPI 1487619722

James J Boutrous is a Urology Physician based in St Clair Shores, MI. James J Boutrous practices in St Clair Shores, MI and has the professional credentials of MD. The NPI Number for James J Boutrous is 1487619722 and holds a License No. 4301028307 (Michigan).

The current practice location address for James J Boutrous is 20952 E 12 Mile Rd, St Clair Shores, MI and can be reached out via phone at 586-771-4820 and via fax at 586-771-6620.

Location: 20952 E 12 Mile Rd, St Clair Shores, MI, 48081-3200
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1487619722
Provider Name
James J Boutrous
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
20952 E 12 Mile Rd, St Clair Shores, MI, 48081-3200
Phone Number
586-771-4820
Fax Number
586-771-6620
Provider Enumeration Date
04/19/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
101289 01 MI PRIORITY HEALTH
4522258 01 MI AETNA
A75907 01 MI HAP
340017814 01 MI RAILROAD MEDICARE
2406964001 01 MI CIGNA
institution
Provider Business Practice Location Address Details
Address
20952 E 12 Mile Rd
City
St Clair Shores
State
Michigan
Zip
48081-3200
Phone Number
586-771-4820
Fax Number
586-771-6620
person
Provider Business Mailing Address Details
Address
20952 E 12 Mile Rd
City
St Clair Shores
State
Michigan
Zip
48081-3200
Phone Number
586-771-4820
Fax Number
586-771-6620
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Urology
Speciality
-
Taxonomy
208800000X
License No.
4301028307 (Michigan)
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
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